Ramírez Adrián Santana, Rodríguez Pedro Ávila, Gutiérrez Sergio Valente Esparza, Ávila Oscar Gutiérrez
Department of Neurosurgery, Hospital Civil "Dr. Juan I. Menchaca", Guadalajara, Jalisco, México.
Surg Neurol Int. 2019 Feb 8;10:17. doi: 10.4103/sni.sni_361_18. eCollection 2019.
In surgery involving brain tumors, the use of new tools or equipment that allows for better results and improvement in the quality of life of the patients is mandatory. Microwave ablation (MWA) is a technique that has been used effectively since 1994 in the management of different kinds of tumors. The authors present their surgical experience with 23 cases of brain and skull-base tumors using MWA technique.
In all, 23 cases diagnosed with brain and skull-base tumors are described; all of these were treated with MWA as unique technique as a complement to conventional microsurgical tumor resection. In all cases, ultrasound imaging guidance was used. A thin antenna (caliber 14.5; MedWaves) was positioned through ultrasound images to a central intratumoral area, and then energy was applied for 1-3 min until the temperature sensor in the proximal position of the antenna reached 80-100°C. Through transoperative Doppler ultrasound images and surgical microscopy, changes in the generated ablation were observed. The said ablation led to a decrease in intratumoral blood flow, and the adjacent vascular and cerebral structures were preserved.
The application of MWA during brain surgery was regarded as safe in all cases, as no permanent additional neurological deficit was detected. Intratumoral vascular flow was also reduced and tumor resection was facilitated. Likewise, a reduction in tumor volume was noted, and in others in whom the ablation was applied as a single therapy, a progressive destruction of the tumor was observed.
MWA can be a useful tool as a single therapy or as a complement to conventional techniques for the surgical resection of brain and skull-base tumors. It was a safe method in all cases, producing a decrease in intratumoral blood flow, and this procedure facilitates the microsurgical resection of the lesion.
在涉及脑肿瘤的手术中，使用能带来更好效果并改善患者生活质量的新工具或设备是必不可少的。微波消融（MWA）是一种自1994年以来已有效应用于各类肿瘤治疗的技术。作者介绍了他们使用MWA技术治疗23例脑和颅底肿瘤的手术经验。
共描述了23例诊断为脑和颅底肿瘤的病例；所有这些病例均采用MWA作为唯一技术，作为传统显微手术肿瘤切除的补充。所有病例均使用超声成像引导。通过超声图像将一根细天线（口径14.5；MedWaves）置于肿瘤中心区域，然后施加能量1 - 3分钟，直到天线近端的温度传感器达到80 - 100°C。通过术中多普勒超声图像和手术显微镜观察所产生消融的变化。上述消融导致肿瘤内血流减少，且相邻血管和脑结构得以保留。
在所有病例中，脑手术中应用MWA均被认为是安全的，因为未检测到永久性的额外神经功能缺损。肿瘤内血管血流也减少，便于肿瘤切除。同样，肿瘤体积减小，在其他将消融作为单一治疗方法的病例中，观察到肿瘤逐渐被破坏。
MWA可作为一种有用的工具，单独用于或作为传统技术的补充，用于脑和颅底肿瘤的手术切除。在所有病例中它都是一种安全的方法，可减少肿瘤内血流，且该操作便于对病变进行显微手术切除。
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